Partial Splenic Embolization for the Management of Severe Refractory Thrombocytopenia in Antiphospholipid Syndrome: A Case Report and Literature Review

2022 ◽  
pp. 153857442110726
Author(s):  
Javad Jalili ◽  
Ramin Pourghorban ◽  
Masoud Mahmoudpour ◽  
Ali Akhavi Milani
Keyword(s):  
Antiphospholipid Syndrome ◽  
Treatment Options ◽  
Common Finding ◽  
Severe Thrombocytopenia ◽  
Primary Antiphospholipid Syndrome ◽  
Partial Splenic Embolization ◽  
Risk Condition ◽  
Splenic Embolization ◽  
Autoimmune Condition ◽  
Almost All

Antiphospholipid syndrome is an autoimmune condition characterized by arteriovenous thromboembolic events. Thrombocytopenia is a common finding among these patients and is typically of mild severity not requiring any treatment. However, severe cases of thrombocytopenia should be treated. Steroids, intravenous immune globulin (IVIG), and immunomodulatory agents are the first-line treatment options, and surgical splenectomy is usually reserved for more severe and refractory cases of thrombocytopenia. Herein, we report the case of a 30-year-old man with primary antiphospholipid syndrome and severe thrombocytopenia. The patient’s thrombocytopenia had been refractory to almost all the medical managements, and surgical splenectomy could not be an option due to the patient’s high-risk condition for surgery. The patient was successfully managed by partial splenic embolization (PSE) which was a unique application of this technique.

scholarly journals Partial Splenic Embolization with Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma Accompanied by Thrombocytopenia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yoshihiko Ooka ◽  
Tetsuhiro Chiba ◽  
Sadahisa Ogasawara ◽  
Tenyu Motoyama ◽  
Eiichiro Suzuki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Failure ◽  
Transarterial Chemoembolization ◽  
Systemic Chemotherapy ◽  
Serum Levels ◽  
Severe Thrombocytopenia ◽  
Partial Splenic Embolization ◽  
Long Term Effects ◽  
Platelet Counts ◽  
Splenic Embolization

Background. Thrombocytopenia often makes the introduction of systemic treatment difficult in patients with cirrhosis and hepatocellular carcinoma (HCC). We retrospectively evaluated the long-term effects of partial splenic embolization (PSE) with transarterial chemoembolization (TACE) in patients with HCC patients accompanied by thrombocytopenia.Patients and Methods. Twenty-one patients with HCC complicated by severe thrombocytopenia (platelet count, <5.0 × 104/mm3) were treated with PSE and TACE. Both the safety and platelet-increasing effect was evaluated in these patients.Results. Seventeen of 21 patients (81.0%) showed increased platelet counts to ≥5.0 × 104/mm3. Subsequently, 13 patients (61.9%) successfully received systemic chemotherapy. Platelet counts and serum levels of total bilirubin, as well as neutrophil counts, improved significantly one month after treatment. However, serum levels of albumin and hemoglobin decreased significantly one month after treatment. Severe adverse events, including acute liver failure and portal vein thrombus, were observed in two patients.Conclusion. PSE with selective TACE made it possible for patients with HCC and severe thrombocytopenia to receive systemic chemotherapy. Although PSE with TACE was safe and tolerable for most patients, the extent of PSE with TACE in a wide area of the liver may increase the risk for fatal liver failure.

scholarly journals Case report: Life-saving pulmonary endarterectomy for a young female with primary antiphospholipid syndrome complicated by severe chronic thromboembolic pulmonary hypertension

2018 ◽  
Vol 24 (1) ◽  
pp. 1-8
Author(s):  
Eglė Palevičiūtė ◽  
Radvilė Malickaitė ◽  
Mindaugas Matačiūnas ◽  
Virginija Šileikienė ◽  
Lina Kryžauskaitė ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Antiphospholipid Syndrome ◽  
Pulmonary Arteries ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Favourable Outcome ◽  
Surgical Removal ◽  
Severe Thrombocytopenia ◽  
Primary Antiphospholipid Syndrome ◽  
Pulmonary Endarterectomy ◽  
Thromboembolic Pulmonary Hypertension

Abstract Background: Prothrombotic state and impaired clot dissolution can contribute to the occurrence of chronic thromboembolic pulmonary hypertension in primary antiphospholipid syndrome. Pulmonary endarterectomy - the surgical removal of the organized thromboembolic material from the proximal pulmonary arteries - is the procedure of choice and potentially a curative option for patients with chronic thromboembolic pulmonary hypertension, including patients with antiphospholipid syndrome. We report an exceptionally severe and complicated case with favourable outcome. Case presentation: We present a case of a successful high risk pulmonary endarterectomy in a 29-year-old female with primary antiphospholipid syndrome and end-stage chronic thromboembolic pulmonary hypertension. Despite highly complicated perioperative course an impressive improvement in symptoms and functional status was achieved. Conclusion: We hope that this complicated but successfully managed case of a combination of two rare diseases will arouse earlier suspicion and timely diagnosis for such patients and will encourage physicians to promptly refer the suitable patients to a pulmonary endarterectomy team. It is important to remember that severe thrombocytopenia may occur in patients with antiphospholipid syndrome

Partial Splenic Embolization for Hypersplenism in Cirrhotic Patients. A Case Series

2014 ◽  
Vol 23 (2) ◽  
pp. 215-218 ◽  
Author(s):  
Secil Omer ◽  
Octavian Zara ◽  
Claudia Iacobescu ◽  
Ion Dina
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Interventional Procedure ◽  
Case Series ◽  
Favourable Outcome ◽  
High Morbidity ◽  
Severe Thrombocytopenia ◽  
Partial Splenic Embolization ◽  
Splenic Embolization ◽  
Prognosis Of Liver Cirrhosis

The prognosis of liver cirrhosis depends on the presence of its major complications as well as on other factors such as hypersplenism with thrombocytopenia. Partial splenic embolization is an effective interventional procedure performed in liver cirrhosis complicated with portal hypertension to improve the low platelet count. This technique represents an efficient alternative to splenectomy, which has major drawbacks and is associated with a high morbidity. We report a series of patients with liver cirrhosis and portal hypertension who presented with severe thrombocytopenia and were treated with partial splenic embolization eventually having a favourable outcome.

Partial splenic embolization in a child with Gaucher disease, massive splenomegaly and severe thrombocytopenia

2009 ◽  
Vol 39 (9) ◽  
pp. 1006-1009 ◽  
Author(s):  
Andres H. Pena ◽  
Paige Kaplan ◽  
Jaya Ganesh ◽  
Egor Clevac ◽  
Anne Marie Cahill
Keyword(s):  
Gaucher Disease ◽  
Severe Thrombocytopenia ◽  
Partial Splenic Embolization ◽  
Massive Splenomegaly ◽  
Splenic Embolization

Correction of severe thrombocytopenia with chloroquine in the primary antiphospholipid syndrome

Lupus ◽  
1996 ◽  
Vol 5 (1) ◽  
pp. 81-83 ◽  
Author(s):  
IM Suarez ◽  
RA Diaz ◽  
D-Aguayo Canela ◽  
E. Pujol de la Llave
Keyword(s):  
Antiphospholipid Syndrome ◽  
Severe Thrombocytopenia ◽  
Primary Antiphospholipid Syndrome

scholarly journals Partial Splenic Embolization as a Bridge to Total Knee Replacement for a Patient with Severe Thrombocytopenia due to Cirrhosis and Splenic Sequestration

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Adrianne Netterville ◽  
Ronald Lands
Keyword(s):  
Portal Hypertension ◽  
Orthopedic Surgery ◽  
Elderly Woman ◽  
Severe Thrombocytopenia ◽  
Partial Splenic Embolization ◽  
Splenic Sequestration ◽  
Remarkable Improvement ◽  
Splenic Embolization ◽  
Total Knee ◽  
Over 40 Years

Medical splenectomy by embolization was originally used to attenuate bleeding from varices in a man with cirrhosis and portal hypertension. Despite the procedure being described over 40 years ago with remarkable improvement in its safety profile and clinical outcomes since, it is still used with variable frequency because of concerns that the risk is high and the results are transient. We present the case of an elderly woman with cirrhosis, portal hypertension, and splenic sequestration who completed partial splenic embolization (PSE) with a durable hematologic response that served as a bridge which allowed her to have orthopedic surgery. A discussion with literature review follows.

A Brief Review on Dual Target of PARP1 and STAT3 for Cancer Therapy: A Novel Perception

2020 ◽  
Vol 16 (2) ◽  
pp. 115-134
Author(s):  
Kaviarasan Lakshmanan ◽  
Gowramma Byran ◽  
Manal Mohammed
Keyword(s):  
Signaling Pathways ◽  
Single Molecule ◽  
Treatment Options ◽  
Poor Response ◽  
Cytotoxic Agents ◽  
Acquired Drug Resistance ◽  
Single Target ◽  
New Strategy ◽  
Cancer Multiple ◽  
Almost All

Background: Cancer is a disease characterized by the uncontrolled growth and spread of abnormal cells. Around the world, over 10 million cancer cases occur annually. Half of all men and one-third of all women will develop some form of cancer during their lifetime. It is one of the most feared diseases, primarily because half of those diagnosed with cancer die from it. There are several treatments available for cancer. Almost all traditional cytotoxic agents suffer from severe toxicities and other undesirable side effects. Objective: In recent years, the development of targeted medicines has made significant achievements. Unfortunately, though these agents can block key regulators of signaling pathways in cancer, multiple compensatory pathways always attenuate pharmacological effect of single-target drugs. In addition, poor response rates and acquired drug resistance also represent a significant barrier to widespread use of targeted medicines. More recently, a number of combinatorial therapies have expanded treatment options, which can directly block several key signaling pathways and create a synergistic effect. Conclusion: Therefore, in order to overcome these barriers, the present investigation aims to develop a new strategy for designing a single molecule with inhibition of two receptors (PARP1 and STAT3) simultaneously and producing enhanced anti-cancer activity with less and/or null toxicity.

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